PARIS – A fast and simple clinically based scoring system enables physicians to determine the chance of a successful outcome for octogenarians undergoing percutaneous coronary intervention, James Cockburn, MD, said at the annual congress of the European Association of Percutaneous Cardiovascular Interventions.

All six elements of the scoring system are readily available either at the time the very elderly patient presents or at diagnostic angiography, noted Dr. Cockburn of Brighton and Sussex University Hospital in Brighton, England.

Bruce Jancin/Frontline Medical News

He and his coworkers developed the risk score through analysis of a registry of 44,221 patients aged 80 or older who underwent percutaneous coronary intervention (PCI). The procedural success rate – defined as less than a 30% residual stenosis and TIMI (Thrombolysis in Myocardial Infarction) 3 antegrade blood flow – was 92.3%. The 30-day mortality rate was 3.9%. The investigators teased out a set of easily accessible clinical factors associated with 30-day mortality and came up with a novel risk scoring system using a 9-point scale.

The clinical factors and scoring system are as follows:

• Age. 1 point for being 80-89, and 2 points at age 90 or older.

• Indication for PCI. 1 point for unstable angina/non–ST segment elevation MI, 2 points for STEMI, 0 points for other indications.

• Ventilated preprocedure. 1 point if yes.

• Creatinine level above 200 umol/L. 1 point for yes.

• Preprocedural cardiogenic shock. 2 points for yes.

• Poor left ventricular ejection fraction. If less than 30%, 1 point.

Thus, scores can range from 1 to 9. Dr. Cockburn and his coworkers calculated the risk of 30-day mortality for each possible score. They validated the score by performing a receiver operator curve analysis that showed an area under the curve of 0.83, suggestive of relatively high sensitivity and specificity.

A score of 4 or less suggests a very good chance of survival at 30 days. In contrast, a score of 6 was associated with a two in three chance of death by 30 days. And it’s not hard to reach a 6: A patient who is 90 years old (2 points), presents with STEMI (2 points), and is in cardiogenic shock (2 points) is already there. But if a 90-year-old patient presents with unstable angina and none of the other risk factors, that’s a score of 3 points, with an estimated probability of death at 30 days of only 7%, he noted.

Dr. Cockburn stressed that this risk score should not be used to base decisions on whether to take very elderly patients to the cardiac catheterization laboratory. “It enables you to have a useful conversation with relatives in which you can explain that this is a very high-risk intervention, or perhaps a low-risk intervention,” according to the cardiologist.

Discussants were emphatic in their agreement with Dr. Cockburn that this risk score shouldn’t be utilized to decide who does or doesn’t get PCI. One panelist said that what’s really lacking now in clinical practice – and where that huge British registry database could be helpful – is a scoring system that would predict which patients who don’t present in cardiogenic shock are going to develop it post PCI.

Dr. Cockburn reported having no relevant financial conflicts.

[email protected]

PARIS – A fast and simple clinically based scoring system enables physicians to determine the chance of a successful outcome for octogenarians undergoing percutaneous coronary intervention, James Cockburn, MD, said at the annual congress of the European Association of Percutaneous Cardiovascular Interventions.

All six elements of the scoring system are readily available either at the time the very elderly patient presents or at diagnostic angiography, noted Dr. Cockburn of Brighton and Sussex University Hospital in Brighton, England.

Bruce Jancin/Frontline Medical News

He and his coworkers developed the risk score through analysis of a registry of 44,221 patients aged 80 or older who underwent percutaneous coronary intervention (PCI). The procedural success rate – defined as less than a 30% residual stenosis and TIMI (Thrombolysis in Myocardial Infarction) 3 antegrade blood flow – was 92.3%. The 30-day mortality rate was 3.9%. The investigators teased out a set of easily accessible clinical factors associated with 30-day mortality and came up with a novel risk scoring system using a 9-point scale.

The clinical factors and scoring system are as follows:

• Age. 1 point for being 80-89, and 2 points at age 90 or older.

• Indication for PCI. 1 point for unstable angina/non–ST segment elevation MI, 2 points for STEMI, 0 points for other indications.

• Ventilated preprocedure. 1 point if yes.

• Creatinine level above 200 umol/L. 1 point for yes.

• Preprocedural cardiogenic shock. 2 points for yes.

• Poor left ventricular ejection fraction. If less than 30%, 1 point.

Thus, scores can range from 1 to 9. Dr. Cockburn and his coworkers calculated the risk of 30-day mortality for each possible score. They validated the score by performing a receiver operator curve analysis that showed an area under the curve of 0.83, suggestive of relatively high sensitivity and specificity.

A score of 4 or less suggests a very good chance of survival at 30 days. In contrast, a score of 6 was associated with a two in three chance of death by 30 days. And it’s not hard to reach a 6: A patient who is 90 years old (2 points), presents with STEMI (2 points), and is in cardiogenic shock (2 points) is already there. But if a 90-year-old patient presents with unstable angina and none of the other risk factors, that’s a score of 3 points, with an estimated probability of death at 30 days of only 7%, he noted.

Dr. Cockburn stressed that this risk score should not be used to base decisions on whether to take very elderly patients to the cardiac catheterization laboratory. “It enables you to have a useful conversation with relatives in which you can explain that this is a very high-risk intervention, or perhaps a low-risk intervention,” according to the cardiologist.

Discussants were emphatic in their agreement with Dr. Cockburn that this risk score shouldn’t be utilized to decide who does or doesn’t get PCI. One panelist said that what’s really lacking now in clinical practice – and where that huge British registry database could be helpful – is a scoring system that would predict which patients who don’t present in cardiogenic shock are going to develop it post PCI.

Dr. Cockburn reported having no relevant financial conflicts.

[email protected]

PARIS – A fast and simple clinically based scoring system enables physicians to determine the chance of a successful outcome for octogenarians undergoing percutaneous coronary intervention, James Cockburn, MD, said at the annual congress of the European Association of Percutaneous Cardiovascular Interventions.

All six elements of the scoring system are readily available either at the time the very elderly patient presents or at diagnostic angiography, noted Dr. Cockburn of Brighton and Sussex University Hospital in Brighton, England.

Bruce Jancin/Frontline Medical News

He and his coworkers developed the risk score through analysis of a registry of 44,221 patients aged 80 or older who underwent percutaneous coronary intervention (PCI). The procedural success rate – defined as less than a 30% residual stenosis and TIMI (Thrombolysis in Myocardial Infarction) 3 antegrade blood flow – was 92.3%. The 30-day mortality rate was 3.9%. The investigators teased out a set of easily accessible clinical factors associated with 30-day mortality and came up with a novel risk scoring system using a 9-point scale.

The clinical factors and scoring system are as follows:

• Age. 1 point for being 80-89, and 2 points at age 90 or older.

• Indication for PCI. 1 point for unstable angina/non–ST segment elevation MI, 2 points for STEMI, 0 points for other indications.

• Ventilated preprocedure. 1 point if yes.

• Creatinine level above 200 umol/L. 1 point for yes.

• Preprocedural cardiogenic shock. 2 points for yes.

• Poor left ventricular ejection fraction. If less than 30%, 1 point.

Thus, scores can range from 1 to 9. Dr. Cockburn and his coworkers calculated the risk of 30-day mortality for each possible score. They validated the score by performing a receiver operator curve analysis that showed an area under the curve of 0.83, suggestive of relatively high sensitivity and specificity.

A score of 4 or less suggests a very good chance of survival at 30 days. In contrast, a score of 6 was associated with a two in three chance of death by 30 days. And it’s not hard to reach a 6: A patient who is 90 years old (2 points), presents with STEMI (2 points), and is in cardiogenic shock (2 points) is already there. But if a 90-year-old patient presents with unstable angina and none of the other risk factors, that’s a score of 3 points, with an estimated probability of death at 30 days of only 7%, he noted.

Dr. Cockburn stressed that this risk score should not be used to base decisions on whether to take very elderly patients to the cardiac catheterization laboratory. “It enables you to have a useful conversation with relatives in which you can explain that this is a very high-risk intervention, or perhaps a low-risk intervention,” according to the cardiologist.

Discussants were emphatic in their agreement with Dr. Cockburn that this risk score shouldn’t be utilized to decide who does or doesn’t get PCI. One panelist said that what’s really lacking now in clinical practice – and where that huge British registry database could be helpful – is a scoring system that would predict which patients who don’t present in cardiogenic shock are going to develop it post PCI.

Dr. Cockburn reported having no relevant financial conflicts.

[email protected]

About 1 in 7 cases of multiple myeloma diagnosed in the United States are cases of smoldering disease, according to an analysis of data from the National Cancer Data Base, which represents 70% of cancer cases.

The prevalence of smoldering multiple myeloma varied among various socio- and geodemographic subgroups, but overall survival did not, Aishwarya Ravindran, MBBS, of Mayo Clinic, Rochester, Minn., and colleagues reported at the annual meeting of the American Society of Clinical Oncology. “Our results can be used in the future to study the health care impact of SMM,” the researchers wrote in a poster presentation.

Courtesy Wikimedia Commons/KGH/Creative Commons License

Epidemiologic studies of smoldering multiple myeloma have been limited by the lack of International Classification of Diseases codes specific for smoldering status, the researchers said.

They analyzed 86,327 cases of multiple myeloma, considering socio- and geodemographic subgroups and type of treatment facility. Overall survival was compared for smoldering and active multiple myeloma. The researchers included patients enrolled in the database during 2003-2011; records were examined from the time to initial treatment and they considered reasons for patients not receiving treatment.

Patients who did not require treatment within the first 120 days after diagnosis were considered to have smoldering disease. This group comprised almost 14% of the cases.

The proportion of cases that were smoldering disease did not change significantly during the study period (P = .23 and .34, respectively). Smoldering disease was more likely to be diagnosed among women, black patients, older patients (median age at diagnosis was 67 years), and less educated patients. Smoldering disease was more common in patients with fewer medical comorbidities, those living closer to a treatment facility, and those evaluated for their disease in the Northeast United States. The proportions of cases diagnosed at academic and nonacademic facilities were similar.

The median overall survival for smoldering disease was 63 months; for active disease, 33 months. Overall survival in those with smoldering disease did not differ among the racial groups (P = .27).

The researchers had no financial conflicts.

[email protected]

On Twitter @maryjodales

About 1 in 7 cases of multiple myeloma diagnosed in the United States are cases of smoldering disease, according to an analysis of data from the National Cancer Data Base, which represents 70% of cancer cases.

The prevalence of smoldering multiple myeloma varied among various socio- and geodemographic subgroups, but overall survival did not, Aishwarya Ravindran, MBBS, of Mayo Clinic, Rochester, Minn., and colleagues reported at the annual meeting of the American Society of Clinical Oncology. “Our results can be used in the future to study the health care impact of SMM,” the researchers wrote in a poster presentation.

Courtesy Wikimedia Commons/KGH/Creative Commons License

Epidemiologic studies of smoldering multiple myeloma have been limited by the lack of International Classification of Diseases codes specific for smoldering status, the researchers said.

They analyzed 86,327 cases of multiple myeloma, considering socio- and geodemographic subgroups and type of treatment facility. Overall survival was compared for smoldering and active multiple myeloma. The researchers included patients enrolled in the database during 2003-2011; records were examined from the time to initial treatment and they considered reasons for patients not receiving treatment.

Patients who did not require treatment within the first 120 days after diagnosis were considered to have smoldering disease. This group comprised almost 14% of the cases.

The proportion of cases that were smoldering disease did not change significantly during the study period (P = .23 and .34, respectively). Smoldering disease was more likely to be diagnosed among women, black patients, older patients (median age at diagnosis was 67 years), and less educated patients. Smoldering disease was more common in patients with fewer medical comorbidities, those living closer to a treatment facility, and those evaluated for their disease in the Northeast United States. The proportions of cases diagnosed at academic and nonacademic facilities were similar.

The median overall survival for smoldering disease was 63 months; for active disease, 33 months. Overall survival in those with smoldering disease did not differ among the racial groups (P = .27).

The researchers had no financial conflicts.

[email protected]

On Twitter @maryjodales

About 1 in 7 cases of multiple myeloma diagnosed in the United States are cases of smoldering disease, according to an analysis of data from the National Cancer Data Base, which represents 70% of cancer cases.

The prevalence of smoldering multiple myeloma varied among various socio- and geodemographic subgroups, but overall survival did not, Aishwarya Ravindran, MBBS, of Mayo Clinic, Rochester, Minn., and colleagues reported at the annual meeting of the American Society of Clinical Oncology. “Our results can be used in the future to study the health care impact of SMM,” the researchers wrote in a poster presentation.

Courtesy Wikimedia Commons/KGH/Creative Commons License

Epidemiologic studies of smoldering multiple myeloma have been limited by the lack of International Classification of Diseases codes specific for smoldering status, the researchers said.

They analyzed 86,327 cases of multiple myeloma, considering socio- and geodemographic subgroups and type of treatment facility. Overall survival was compared for smoldering and active multiple myeloma. The researchers included patients enrolled in the database during 2003-2011; records were examined from the time to initial treatment and they considered reasons for patients not receiving treatment.

Patients who did not require treatment within the first 120 days after diagnosis were considered to have smoldering disease. This group comprised almost 14% of the cases.

The proportion of cases that were smoldering disease did not change significantly during the study period (P = .23 and .34, respectively). Smoldering disease was more likely to be diagnosed among women, black patients, older patients (median age at diagnosis was 67 years), and less educated patients. Smoldering disease was more common in patients with fewer medical comorbidities, those living closer to a treatment facility, and those evaluated for their disease in the Northeast United States. The proportions of cases diagnosed at academic and nonacademic facilities were similar.

The median overall survival for smoldering disease was 63 months; for active disease, 33 months. Overall survival in those with smoldering disease did not differ among the racial groups (P = .27).

The researchers had no financial conflicts.

[email protected]

On Twitter @maryjodales

19th Annual C. Walton Lillehei Resident Forum
Through a generous unrestricted educational grant from St. Jude Medical, the Forum enables eight residents to present and compete for a $5,000 award.

Rachel D. Vanderlaan /University of Toronto
“Mechanistic Insights into the Pathophysiology of Pulmonary Vein Stenosis”

Moderated Poster Competition

Adult Cardiac
Sameh M. Said/Mayo Clinic
“Long-term Outcomes of Surgery for Infective Endocarditis: A Single-center Experience of 801 Patients”

Congenital
Sachin Talwar/All India Institute of Medical Sciences
“Oral Thyroxin Supplementation in Infants Undergoing Cardiac Surgery: A Double Blind Randomized Clinical Trial”

General Thoracic
Jules Lin/University of Michigan
“Analytic Morphomics Predict Outcomes After Lung Volume Reduction Surgery”

19th Annual C. Walton Lillehei Resident Forum
Through a generous unrestricted educational grant from St. Jude Medical, the Forum enables eight residents to present and compete for a $5,000 award.

Rachel D. Vanderlaan /University of Toronto
“Mechanistic Insights into the Pathophysiology of Pulmonary Vein Stenosis”

Moderated Poster Competition

Adult Cardiac
Sameh M. Said/Mayo Clinic
“Long-term Outcomes of Surgery for Infective Endocarditis: A Single-center Experience of 801 Patients”

Congenital
Sachin Talwar/All India Institute of Medical Sciences
“Oral Thyroxin Supplementation in Infants Undergoing Cardiac Surgery: A Double Blind Randomized Clinical Trial”

General Thoracic
Jules Lin/University of Michigan
“Analytic Morphomics Predict Outcomes After Lung Volume Reduction Surgery”

19th Annual C. Walton Lillehei Resident Forum
Through a generous unrestricted educational grant from St. Jude Medical, the Forum enables eight residents to present and compete for a $5,000 award.

Rachel D. Vanderlaan /University of Toronto
“Mechanistic Insights into the Pathophysiology of Pulmonary Vein Stenosis”

Moderated Poster Competition

Adult Cardiac
Sameh M. Said/Mayo Clinic
“Long-term Outcomes of Surgery for Infective Endocarditis: A Single-center Experience of 801 Patients”

Congenital
Sachin Talwar/All India Institute of Medical Sciences
“Oral Thyroxin Supplementation in Infants Undergoing Cardiac Surgery: A Double Blind Randomized Clinical Trial”

General Thoracic
Jules Lin/University of Michigan
“Analytic Morphomics Predict Outcomes After Lung Volume Reduction Surgery”

AATS Week 2016 was a great success

Starting May 12 and 13 in New York City, more than 1,250 attendees took part in the AATS Aortic Symposium. The Friday Breakfast Sessions were particularly popular — Stump the Stars I: Open Surgery Cases, Stump the Stars II: Endovascular Cases, and Controversies in Aortic Surgery.

The week’s activities continued from May 14 - 18 at the AATS Annual Meeting in Baltimore. On hand were some 2,514 cardiothoracic surgeons and health care professionals, as well as residents, fellows, medical students and others in the field.

Program Highlights

Saturday Skills Courses:Combined Luncheon Speaker Denton A. Cooley, followed by hands-on sessions.

Sunday Postgraduate Symposia with Legends Luncheons featuring Leonard L. Bailey, Joel D. Cooper and John L. Ochsner.

New course: The Survival Guide for the Cardiothoracic Surgical Team aimed at residents, fellows and health care professionals, followed by a hands-on session.

Emerging Technologies & Techniques Fora: Adult Cardiac and General Thoracic

Surgical Ethics Course: Surgeons Solving Ethical Problems in Surgery — A day-long program focusing on ethical issues faced by surgeons, especially problems created by rapidly evolving technologies. Course chairs were Martin F. McKneally, University of Toronto and Robert M. Sade, Medical University of South Carolina.

VAD/ECMO Session

Masters of Surgery Video Sessions

AATS Learning Center — Located in the Exhibit Hall, the Center had nine stations of cutting-edge case videos of novel procedures and surgical techniques. Subject areas were: the “best” of the 2015 Mitral Conclave and 2016 Aortic Symposium, aortic surgery, congenital heart disease, esophagus and diaphragm, intracardiac masses, lung, mediastinum, and mitral valve surgery.

More Highlights @ The AATS Daily News 

AATS Week 2016 was a great success

Starting May 12 and 13 in New York City, more than 1,250 attendees took part in the AATS Aortic Symposium. The Friday Breakfast Sessions were particularly popular — Stump the Stars I: Open Surgery Cases, Stump the Stars II: Endovascular Cases, and Controversies in Aortic Surgery.

The week’s activities continued from May 14 - 18 at the AATS Annual Meeting in Baltimore. On hand were some 2,514 cardiothoracic surgeons and health care professionals, as well as residents, fellows, medical students and others in the field.

Program Highlights

Saturday Skills Courses:Combined Luncheon Speaker Denton A. Cooley, followed by hands-on sessions.

Sunday Postgraduate Symposia with Legends Luncheons featuring Leonard L. Bailey, Joel D. Cooper and John L. Ochsner.

New course: The Survival Guide for the Cardiothoracic Surgical Team aimed at residents, fellows and health care professionals, followed by a hands-on session.

Emerging Technologies & Techniques Fora: Adult Cardiac and General Thoracic

Surgical Ethics Course: Surgeons Solving Ethical Problems in Surgery — A day-long program focusing on ethical issues faced by surgeons, especially problems created by rapidly evolving technologies. Course chairs were Martin F. McKneally, University of Toronto and Robert M. Sade, Medical University of South Carolina.

VAD/ECMO Session

Masters of Surgery Video Sessions

AATS Learning Center — Located in the Exhibit Hall, the Center had nine stations of cutting-edge case videos of novel procedures and surgical techniques. Subject areas were: the “best” of the 2015 Mitral Conclave and 2016 Aortic Symposium, aortic surgery, congenital heart disease, esophagus and diaphragm, intracardiac masses, lung, mediastinum, and mitral valve surgery.

More Highlights @ The AATS Daily News 

AATS Week 2016 was a great success

Starting May 12 and 13 in New York City, more than 1,250 attendees took part in the AATS Aortic Symposium. The Friday Breakfast Sessions were particularly popular — Stump the Stars I: Open Surgery Cases, Stump the Stars II: Endovascular Cases, and Controversies in Aortic Surgery.

The week’s activities continued from May 14 - 18 at the AATS Annual Meeting in Baltimore. On hand were some 2,514 cardiothoracic surgeons and health care professionals, as well as residents, fellows, medical students and others in the field.

Program Highlights

Saturday Skills Courses:Combined Luncheon Speaker Denton A. Cooley, followed by hands-on sessions.

Sunday Postgraduate Symposia with Legends Luncheons featuring Leonard L. Bailey, Joel D. Cooper and John L. Ochsner.

New course: The Survival Guide for the Cardiothoracic Surgical Team aimed at residents, fellows and health care professionals, followed by a hands-on session.

Emerging Technologies & Techniques Fora: Adult Cardiac and General Thoracic

Surgical Ethics Course: Surgeons Solving Ethical Problems in Surgery — A day-long program focusing on ethical issues faced by surgeons, especially problems created by rapidly evolving technologies. Course chairs were Martin F. McKneally, University of Toronto and Robert M. Sade, Medical University of South Carolina.

VAD/ECMO Session

Masters of Surgery Video Sessions

AATS Learning Center — Located in the Exhibit Hall, the Center had nine stations of cutting-edge case videos of novel procedures and surgical techniques. Subject areas were: the “best” of the 2015 Mitral Conclave and 2016 Aortic Symposium, aortic surgery, congenital heart disease, esophagus and diaphragm, intracardiac masses, lung, mediastinum, and mitral valve surgery.

More Highlights @ The AATS Daily News 

Attendees in Baltimore had the opportunity to experience several terrific talks by top speakers:

Joseph S. Coselli, Baylor College of Medicine
Presidential Address
Competition: Perspiration to Inspiration “Aut viam inveniam aut faciam”

Gary H. Gibbons, National Heart, Blood & Lung Institute
Basic Science Lecture
Charting Our Future Together: Translating Discovery Science into Health Impact

Brian Kelly, Notre Dame Head Football Coach
Honored Guest Lecture
The Building Blocks for Success: Leadership — Program Building — Player Development

Attendees in Baltimore had the opportunity to experience several terrific talks by top speakers:

Joseph S. Coselli, Baylor College of Medicine
Presidential Address
Competition: Perspiration to Inspiration “Aut viam inveniam aut faciam”

Gary H. Gibbons, National Heart, Blood & Lung Institute
Basic Science Lecture
Charting Our Future Together: Translating Discovery Science into Health Impact

Brian Kelly, Notre Dame Head Football Coach
Honored Guest Lecture
The Building Blocks for Success: Leadership — Program Building — Player Development

Attendees in Baltimore had the opportunity to experience several terrific talks by top speakers:

Joseph S. Coselli, Baylor College of Medicine
Presidential Address
Competition: Perspiration to Inspiration “Aut viam inveniam aut faciam”

Gary H. Gibbons, National Heart, Blood & Lung Institute
Basic Science Lecture
Charting Our Future Together: Translating Discovery Science into Health Impact

Brian Kelly, Notre Dame Head Football Coach
Honored Guest Lecture
The Building Blocks for Success: Leadership — Program Building — Player Development

Denton A. Cooley of the Texas Heart Institute was honored with the 2016 AATS Lifetime Achievement Award during the Annual Meeting Plenary Session on Monday, May 16th.

The award was accepted by his daughter (above right) from Dr. Joseph Coselli.

The award recognizes individuals for their significant contributions to CT surgery patient care, teaching, research or community service.

The honor acknowledges Cooley’s dedication, service and pioneering efforts, including the first successful human heart transplant in the United States and first artificial heart implant.

Denton A. Cooley of the Texas Heart Institute was honored with the 2016 AATS Lifetime Achievement Award during the Annual Meeting Plenary Session on Monday, May 16th.

The award was accepted by his daughter (above right) from Dr. Joseph Coselli.

The award recognizes individuals for their significant contributions to CT surgery patient care, teaching, research or community service.

The honor acknowledges Cooley’s dedication, service and pioneering efforts, including the first successful human heart transplant in the United States and first artificial heart implant.

Denton A. Cooley of the Texas Heart Institute was honored with the 2016 AATS Lifetime Achievement Award during the Annual Meeting Plenary Session on Monday, May 16th.

The award was accepted by his daughter (above right) from Dr. Joseph Coselli.

The award recognizes individuals for their significant contributions to CT surgery patient care, teaching, research or community service.

The honor acknowledges Cooley’s dedication, service and pioneering efforts, including the first successful human heart transplant in the United States and first artificial heart implant.

Has your patient’s opioid use escalated to opioid addiction? How can you tell, and what interventions can you take to help this patient in the context of a 15-minute appointment?

In this edition of Mental Health Consult, our panel discusses their recommendations for workup and next steps for managing a 45-year-old man who has no history of psychiatric disorders and appears to now be dependent on the opioid painkillers that he initially received after a back injury.

Join our panel of experts from George Washington University, Washington, including Daniel Lieberman, MD, professor of psychiatry and behavioral sciences clinical director; April Barbour, MD, MPH, director of the division of general internal medicine; and Lorenzo Norris, MD, medical director of psychiatric and behavioral services, as they discuss how to treat pain medication–related addiction, including when to refer to pain specialists and how various practice models drive treatment decisions and reimbursement.

Click here for a PDF of the case study.

Vidyard Video

Has your patient’s opioid use escalated to opioid addiction? How can you tell, and what interventions can you take to help this patient in the context of a 15-minute appointment?

In this edition of Mental Health Consult, our panel discusses their recommendations for workup and next steps for managing a 45-year-old man who has no history of psychiatric disorders and appears to now be dependent on the opioid painkillers that he initially received after a back injury.

Join our panel of experts from George Washington University, Washington, including Daniel Lieberman, MD, professor of psychiatry and behavioral sciences clinical director; April Barbour, MD, MPH, director of the division of general internal medicine; and Lorenzo Norris, MD, medical director of psychiatric and behavioral services, as they discuss how to treat pain medication–related addiction, including when to refer to pain specialists and how various practice models drive treatment decisions and reimbursement.

Click here for a PDF of the case study.

Vidyard Video

Has your patient’s opioid use escalated to opioid addiction? How can you tell, and what interventions can you take to help this patient in the context of a 15-minute appointment?

In this edition of Mental Health Consult, our panel discusses their recommendations for workup and next steps for managing a 45-year-old man who has no history of psychiatric disorders and appears to now be dependent on the opioid painkillers that he initially received after a back injury.

Join our panel of experts from George Washington University, Washington, including Daniel Lieberman, MD, professor of psychiatry and behavioral sciences clinical director; April Barbour, MD, MPH, director of the division of general internal medicine; and Lorenzo Norris, MD, medical director of psychiatric and behavioral services, as they discuss how to treat pain medication–related addiction, including when to refer to pain specialists and how various practice models drive treatment decisions and reimbursement.

Click here for a PDF of the case study.

Vidyard Video

Has your patient’s opioid use escalated to opioid addiction? How can you tell, and what interventions can you take to help this patient in the context of a 15-minute appointment?

In this edition of Mental Health Consult, our panel discusses their recommendations for workup and next steps for managing a 45-year-old man who has no history of psychiatric disorders and appears to now be dependent on the opioid painkillers that he initially received after a back injury.

Join our panel of experts from George Washington University, Washington, including Daniel Lieberman, MD, professor of psychiatry and behavioral sciences clinical director; April Barbour, MD, MPH, director of the division of general internal medicine; and Lorenzo Norris, MD, medical director of psychiatric and behavioral services, as they discuss how to treat pain medication–related addiction, including when to refer to pain specialists and how various practice models drive treatment decisions and reimbursement.

[email protected]

On Twitter @whitneymcknight

Has your patient’s opioid use escalated to opioid addiction? How can you tell, and what interventions can you take to help this patient in the context of a 15-minute appointment?

In this edition of Mental Health Consult, our panel discusses their recommendations for workup and next steps for managing a 45-year-old man who has no history of psychiatric disorders and appears to now be dependent on the opioid painkillers that he initially received after a back injury.

Join our panel of experts from George Washington University, Washington, including Daniel Lieberman, MD, professor of psychiatry and behavioral sciences clinical director; April Barbour, MD, MPH, director of the division of general internal medicine; and Lorenzo Norris, MD, medical director of psychiatric and behavioral services, as they discuss how to treat pain medication–related addiction, including when to refer to pain specialists and how various practice models drive treatment decisions and reimbursement.

[email protected]

On Twitter @whitneymcknight

Has your patient’s opioid use escalated to opioid addiction? How can you tell, and what interventions can you take to help this patient in the context of a 15-minute appointment?

In this edition of Mental Health Consult, our panel discusses their recommendations for workup and next steps for managing a 45-year-old man who has no history of psychiatric disorders and appears to now be dependent on the opioid painkillers that he initially received after a back injury.

Join our panel of experts from George Washington University, Washington, including Daniel Lieberman, MD, professor of psychiatry and behavioral sciences clinical director; April Barbour, MD, MPH, director of the division of general internal medicine; and Lorenzo Norris, MD, medical director of psychiatric and behavioral services, as they discuss how to treat pain medication–related addiction, including when to refer to pain specialists and how various practice models drive treatment decisions and reimbursement.

[email protected]

On Twitter @whitneymcknight

Tirone E. David of the University of Toronto was presented with the 2016 AATS Scientific Achievement Award during the Annual Meeting Plenary Session on May 16th.

Dr. David (above left) with his award is shown with Dr. Irving Kron.

The award is the Association’s highest scientific recognition. Created in 1994, it recognizes physicians who have made extraordinary scientific contributions to the CT surgery field.

The honor acknowledges David’s pioneering work in CT surgery and his service as 85th AATS President (2004-2005). During an illustrious career, his innovation, passion and dedication to CT surgery has impacted hundreds of trainees and peers. The David operation revolutionized the treatment of aortic valve disease and resulted in substantial advances in patient care quality worldwide.

Tirone E. David of the University of Toronto was presented with the 2016 AATS Scientific Achievement Award during the Annual Meeting Plenary Session on May 16th.

Dr. David (above left) with his award is shown with Dr. Irving Kron.

The award is the Association’s highest scientific recognition. Created in 1994, it recognizes physicians who have made extraordinary scientific contributions to the CT surgery field.

The honor acknowledges David’s pioneering work in CT surgery and his service as 85th AATS President (2004-2005). During an illustrious career, his innovation, passion and dedication to CT surgery has impacted hundreds of trainees and peers. The David operation revolutionized the treatment of aortic valve disease and resulted in substantial advances in patient care quality worldwide.

Tirone E. David of the University of Toronto was presented with the 2016 AATS Scientific Achievement Award during the Annual Meeting Plenary Session on May 16th.

Dr. David (above left) with his award is shown with Dr. Irving Kron.

The award is the Association’s highest scientific recognition. Created in 1994, it recognizes physicians who have made extraordinary scientific contributions to the CT surgery field.

The honor acknowledges David’s pioneering work in CT surgery and his service as 85th AATS President (2004-2005). During an illustrious career, his innovation, passion and dedication to CT surgery has impacted hundreds of trainees and peers. The David operation revolutionized the treatment of aortic valve disease and resulted in substantial advances in patient care quality worldwide.

At the Annual Meeting, 55 surgeons were elected as active AATS members:

George M. Alfieris (Rochester, NY)
Denis Bouchard (Montréal, Canada)
Ross M. Bremner (Phoenix, AZ)
Christian P. Brizard (Parkville, Australia)
Manuel Castella (Barcelona, Spain)
Renzo Cecere (Montréal, Canada)
Paul J. Chai (New York, NY)
Toyofumi F. Chen-Yoshikawa (Kyoto, Japan)
Francisco D.A. Costa (Curitiba, Brazil)
Philippe Demers (Montréal, Canada)
Benoit de Varennes (Montréal, Canada)
Roberto Di Bartolomeo (Bologna, Italy)
Nianguo Dong (Wuhan, China)
John R. Doty (Murray, UT)
Sitaram M. Emani (Boston, MA)
Jose I. Fragata (Lisbon, Portugal)
James J. Gangemi (Charlottesville, VA)
Isaac George (New York, NY)
Sebastien Gilbert (Ottawa, Canada)
Diego Gonzalez Rivas (Coruña, Spain)
Jie He (Beijing, China)
Tain-Yen Hsia (London, United Kingdom)
Aditya K. Kaza (Boston, MA)
Michael S. Kent (Boston, MA)
Zain I. Khalpey (Tucson, AZ)
Ahmet Kilic (Columbus, OH)
Joo Hyun Kim (Seoul, Republic of Korea)
Takushi Kohmoto (Madison,WI)
Buu-Khanh Lam (Ottawa, Canada)
Joseph Lamelas (Miami Beach, FL)
Hui Li (Beijing, China)
Brian E. Louie (Seattle, WA)
Giovanni Battista Luciani (Verona, Italy)
Shari L. Meyerson (Chicago, IL)
Siamak Mohammadi (Québec City, Canada)
Katie S. Nason (Pittsburgh, PA)
Shigeyuki Ozaki (Tokyo, Japan)
Amit N. Patel (Salt Lake City, UT)
Michel Pellerin (Montréal, Canada)
Mark D. Peterson (Toronto, Canada)
Eyal E. Porat (Houston, TX)
Michael F. Reed (Hershey, PA)
Kisaburo Sakamoto (Shizuoka, Japan)
Arash Salemi (New York, NY)
Norihiko Shiiya (Hamamatsu, Japan)
Hiroo Takayama (New York, NY)
Sachin Talwar (New Delhi, India)
Tomasz Timek (Grand Rapids, MI)
Joseph W. Turek (Iowa City, IA)
Pierre Voisine (Quebec, Canada)
Benny Weksler (Memphis, TN)
Grayson H. Wheatley (Philadelphia, PA)
Ronald K. Woods (Milwaukee, WI)
Hitoshi Yaku (Kyoto, Japan)
Tae-Jin Yun (Seoul, Republic of Korea)

At the Annual Meeting, 55 surgeons were elected as active AATS members:

George M. Alfieris (Rochester, NY)
Denis Bouchard (Montréal, Canada)
Ross M. Bremner (Phoenix, AZ)
Christian P. Brizard (Parkville, Australia)
Manuel Castella (Barcelona, Spain)
Renzo Cecere (Montréal, Canada)
Paul J. Chai (New York, NY)
Toyofumi F. Chen-Yoshikawa (Kyoto, Japan)
Francisco D.A. Costa (Curitiba, Brazil)
Philippe Demers (Montréal, Canada)
Benoit de Varennes (Montréal, Canada)
Roberto Di Bartolomeo (Bologna, Italy)
Nianguo Dong (Wuhan, China)
John R. Doty (Murray, UT)
Sitaram M. Emani (Boston, MA)
Jose I. Fragata (Lisbon, Portugal)
James J. Gangemi (Charlottesville, VA)
Isaac George (New York, NY)
Sebastien Gilbert (Ottawa, Canada)
Diego Gonzalez Rivas (Coruña, Spain)
Jie He (Beijing, China)
Tain-Yen Hsia (London, United Kingdom)
Aditya K. Kaza (Boston, MA)
Michael S. Kent (Boston, MA)
Zain I. Khalpey (Tucson, AZ)
Ahmet Kilic (Columbus, OH)
Joo Hyun Kim (Seoul, Republic of Korea)
Takushi Kohmoto (Madison,WI)
Buu-Khanh Lam (Ottawa, Canada)
Joseph Lamelas (Miami Beach, FL)
Hui Li (Beijing, China)
Brian E. Louie (Seattle, WA)
Giovanni Battista Luciani (Verona, Italy)
Shari L. Meyerson (Chicago, IL)
Siamak Mohammadi (Québec City, Canada)
Katie S. Nason (Pittsburgh, PA)
Shigeyuki Ozaki (Tokyo, Japan)
Amit N. Patel (Salt Lake City, UT)
Michel Pellerin (Montréal, Canada)
Mark D. Peterson (Toronto, Canada)
Eyal E. Porat (Houston, TX)
Michael F. Reed (Hershey, PA)
Kisaburo Sakamoto (Shizuoka, Japan)
Arash Salemi (New York, NY)
Norihiko Shiiya (Hamamatsu, Japan)
Hiroo Takayama (New York, NY)
Sachin Talwar (New Delhi, India)
Tomasz Timek (Grand Rapids, MI)
Joseph W. Turek (Iowa City, IA)
Pierre Voisine (Quebec, Canada)
Benny Weksler (Memphis, TN)
Grayson H. Wheatley (Philadelphia, PA)
Ronald K. Woods (Milwaukee, WI)
Hitoshi Yaku (Kyoto, Japan)
Tae-Jin Yun (Seoul, Republic of Korea)

At the Annual Meeting, 55 surgeons were elected as active AATS members:

George M. Alfieris (Rochester, NY)
Denis Bouchard (Montréal, Canada)
Ross M. Bremner (Phoenix, AZ)
Christian P. Brizard (Parkville, Australia)
Manuel Castella (Barcelona, Spain)
Renzo Cecere (Montréal, Canada)
Paul J. Chai (New York, NY)
Toyofumi F. Chen-Yoshikawa (Kyoto, Japan)
Francisco D.A. Costa (Curitiba, Brazil)
Philippe Demers (Montréal, Canada)
Benoit de Varennes (Montréal, Canada)
Roberto Di Bartolomeo (Bologna, Italy)
Nianguo Dong (Wuhan, China)
John R. Doty (Murray, UT)
Sitaram M. Emani (Boston, MA)
Jose I. Fragata (Lisbon, Portugal)
James J. Gangemi (Charlottesville, VA)
Isaac George (New York, NY)
Sebastien Gilbert (Ottawa, Canada)
Diego Gonzalez Rivas (Coruña, Spain)
Jie He (Beijing, China)
Tain-Yen Hsia (London, United Kingdom)
Aditya K. Kaza (Boston, MA)
Michael S. Kent (Boston, MA)
Zain I. Khalpey (Tucson, AZ)
Ahmet Kilic (Columbus, OH)
Joo Hyun Kim (Seoul, Republic of Korea)
Takushi Kohmoto (Madison,WI)
Buu-Khanh Lam (Ottawa, Canada)
Joseph Lamelas (Miami Beach, FL)
Hui Li (Beijing, China)
Brian E. Louie (Seattle, WA)
Giovanni Battista Luciani (Verona, Italy)
Shari L. Meyerson (Chicago, IL)
Siamak Mohammadi (Québec City, Canada)
Katie S. Nason (Pittsburgh, PA)
Shigeyuki Ozaki (Tokyo, Japan)
Amit N. Patel (Salt Lake City, UT)
Michel Pellerin (Montréal, Canada)
Mark D. Peterson (Toronto, Canada)
Eyal E. Porat (Houston, TX)
Michael F. Reed (Hershey, PA)
Kisaburo Sakamoto (Shizuoka, Japan)
Arash Salemi (New York, NY)
Norihiko Shiiya (Hamamatsu, Japan)
Hiroo Takayama (New York, NY)
Sachin Talwar (New Delhi, India)
Tomasz Timek (Grand Rapids, MI)
Joseph W. Turek (Iowa City, IA)
Pierre Voisine (Quebec, Canada)
Benny Weksler (Memphis, TN)
Grayson H. Wheatley (Philadelphia, PA)
Ronald K. Woods (Milwaukee, WI)
Hitoshi Yaku (Kyoto, Japan)
Tae-Jin Yun (Seoul, Republic of Korea)